Opinion

James E. Causey | In My Opinion

30 years on, a fear of stigma remains

Volunteers at Diverse & Resilient label condoms to be distributed freely at PrideFest this weekend. Lonell McGrath (left) Marvin High, Kim Sharp, and Ronnie Grace gather the packages at the offices last week. The agency is at the forefront of fighting HIV in the black community through a number of programs.

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A year ago, Gary Hollander suffered a heart attack. He recovered but says he shouldn't be alive today. That's not because of the heart attack, though; it's because he is an older, white, gay man growing up in the time of HIV/AIDS.

"You really don't see many white, gay men around my age today. I've known at least 250 people to die from the disease," said Hollander, 62.

But in the 30 years since the first cases of HIV were recognized on June 5, 1981, some things have become radically different, while others remain remarkably the same.

The so-called Gay Plague has gone from something that once overwhelmingly hit gay, white men to a virus whose main culprit is black, gay and bisexual men, ages 13 to 29. The same homophobia and stigma that surrounded the virus 30 years ago persist.

In Milwaukee, more than 40% of black men who have sex with men are HIV-positive. Nationally, at some point in their lives, one in 16 African-American men will be diagnosed with HIV infection. For young, African-American, gay and bisexual men in Milwaukee, that number becomes one in three, according to the Centers for Disease Control and Prevention.

The center sent a team of investigators to Milwaukee in late 2009 to find out why. Since their visit, Milwaukee appears to be heading in the right direction, although it will be years until we know for sure.

Hollander is executive director for Diverse & Resilient, a nonprofit agency that was given a $60,000 grant a year ago to design an action plan to address HIV in the black community.

Over the past year, the agency has held focus groups, started community outreach and developed both short- and long-term plans to address the problem. The agency is seeking a $2 million grant from the CDC to do even more. The CDC should provide the city the tools needed to fight this epidemic.

Short term, though, there must be a continued emphasis on knowing one's status.

A USA Today analysis last week showed that the states with the biggest epidemics of HIV also have the largest number of infected people who aren't diagnosed until they're on the brink of AIDS.

CDC experts have estimated that 20% of people infected with HIV don't even know it, and one-third are diagnosed so late that they develop AIDS within a year.

In Milwaukee, Hollander said there will be a big push to get more people tested during PrideFest, which celebrates lesbian, gay, bisexual and transgender culture. The festival ends Sunday.

In 2009, 225 people were tested at PrideFest, but only 10 were black. Last year, 596 people were tested, 83 of them black. The goal this year is 1,000 people, with 100 being African-American.

The agency should come up with ways to reach gay and bisexual black men who may not attend LGBT events because they generally are not open about their lifestyle.

Testing is still important because HIV therapy can cut the risk of passing HIV to another person by 96%.

The agency also has trained 30 Milwaukee Public Schools health teachers and 20 psychologists on how to incorporate HIV prevention into their curricula and on how to respond to the needs of LGBT youth - a first for MPS.

Training also has taken place with instructors at the United Way of Greater Milwaukee and with black churches, which, for the most part, have been silent on this issue.

Some black churches have been reluctant to talk about sexual health because of the HIV stigma and the thought that accepting HIV means accepting homosexuality, which is still viewed as a sin.

But it's time for black churches to remove their blindfolds because some of the men who carry this virus attend church and some have sex with women, too.

Long term: The HIV conversation needs to focus on preventing the spread of the disease.

This conversation becomes even more important when you are dealing with black males as young as 16 or 17.

Hollander said some of these men are dealing with so many problems that they figure it's best not to know their status. But this shouldn't be a game of Russian roulette; these men need to be educated on how to protect themselves and their partners.

HIV prevention becomes harder when you mix in all of the other factors.

Sure, you can tell someone that safe sex is important, but when you factor in poverty, joblessness, the high rate of incarceration, lack of education and a sense of hopelessness due to the stigma of being gay, some of these men become hard to reach.

"If your family doesn't accept you because you're gay, and the church doesn't accept your lifestyle, then what are you going to do?" Hollander asked me.

A better question is who will you turn to?

Safe social outlets are needed, but in Milwaukee they are hard to find, according to a Youth Risk Behavior Survey.

According to the survey: 20.5% of high school kids have been in a fight; 14% have been threatened with a weapon at school; and nearly 30% have experienced dating violence. The study did not break down the numbers for LGBT youths in Milwaukee or the state, but I would imagine the numbers are even higher for that group.

A lot has been learned about HIV over the past 30 years. I hope it doesn't take another 30 years for people to feel as though they can express who they are without worrying about being stigmatized.